Drug therapy — Finasteride / Dutasteride / Minoxidil / Spironolactone
Key specs
- Finasteride 1 mg oral, daily — selective 5α-reductase type II inhibitor; reduces scalp DHT and slows miniaturisation in androgenetic alopecia. Strong RCT evidence (Kaufman 1998).
- Dutasteride 0.5 mg oral, daily — dual 5α-reductase inhibitor (types I + II) with greater DHT suppression; useful when Finasteride alone is insufficient.
- Minoxidil — topical 5% solution or low-dose oral (0.25-2.5 mg/day, off-label); vasodilator with proposed potassium-channel-opener mechanism.
- Spironolactone — oral, used for female pattern hair loss as an anti-androgen alternative to Finasteride.
- Side-effect profile, bloodwork (ferritin / thyroid / hormone panel where relevant), and follow-up at 3 and 6 months are reviewed at consultation.

